Individual provider Active NPI

Jonathan Edward Martin, M.D.

  • Family Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1831179191
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G3586 Issued in TX
Practice address
601 Texan TRL
Suite 200
Corpus Christi, TX 78411-2547
Phone
(361) 808-7200
Fax
(361) 653-0431
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G3586 TX Primary

Addresses

Primary practice location

601 Texan TRL
Suite 200
Corpus Christi, TX 78411-2547

Mailing address

601 Texan TRL
Suite 200
Corpus Christi, TX 78411-2547
Phone (361) 808-7200

Other identifiers 2

IdentifierTypeStateIssuer
097438803MedicaidTX
8G6840OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100526000702 TX Practitioner - Family Practice 2961531132 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G3586TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Corpus Christi Family Medicine Center PA Family Medicine CurrentSince Oct 1, 2002 Accepting new patients

Locations

601 Texan Trl
Ste 200
Corpus Christi, TX 78411
Phone (361) 225-2255

601 Texan Trl
Corpus Christi, TX 78411
Phone (361) 696-6238

Interoperability endpoints

  • Direct secure messaging: jonathan.martin@415054778073092.direct.elationemr.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1831179191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 TEXAN TRL",
            "address_2": "SUITE 200",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784112547",
            "telephone_number": "361-808-7200",
            "fax_number": "361-653-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 TEXAN TRL",
            "address_2": "SUITE 200",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784112547",
            "telephone_number": "361-808-7200",
            "fax_number": "361-653-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JONATHAN",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G3586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097438803",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8G6840",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.